Proficiency test for screening mammography: results for 117 volunteer Italian radiologists

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Abstract
Objective To analyse the performance of a large sample of Italian radiologists undergoing a proficiency test for screening mammography. Design Evaluation of performance indicators according to reference standards determined by a panel of experts (sensitivity (reference standard ≥80%), recall rate (reference standard ≤15%)). Setting 117 Italian radiologists of varying experience (years of practice 0.5–18, average 5.9; mammograms read 500–51 000, average 13 000), all currently reporting clinical mammography and planning to take part in screening in the near future. Results Eighty four of 117 (72%) radiologists reached the standard for sensitivity, 88 (75%) reached the standard for recall rate, and only 59 (50%) reached both standards and passed the proficiency test. The probability of passing the test was significantly correlated with mammographic practice (p=0.015), mammograms read (p=0.024), and mammograms read/year (p=0.043). Discussion The performance of a large sample of Italian radiologists currently reporting clinical mammography was disappointing, indicating the need for proper training of at least 50% of the tested subjects. When implementing organised screening the health authority should set up a proper process for training and accrediting radiologists, and a proficiency test should be part of such a process.

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